This World Voice Day, we shine a light on the importance of our voice and how Peter Mac’s speech pathologists can help.
World Voice Day takes place annually on 16 April to celebrate the phenomenon of voice and its importance in our daily lives.
Here at Peter Mac, our speech pathologists assess and manage speech and communication issues affecting our patients, including issues with voice, voice quality and the production of voice. This World Voice Day, our speech pathology team teach us more about the voice, how voice changes can impact people with cancer, and what speech pathology can do to help.
How does the voice work?
When functioning well, the larynx generates voice by using complex and coordinated control of the vocal folds. The vocal folds then vibrate to create sound as air from the lungs passes across them. The voice or spoken word results from three components:
- Voice sound and respiration – The vocal folds open and close rapidly, trapping air as we breathe out and make sound. A change to the mucosal layers of the vocal folds can affect the vocal quality and make the voice sound rough, breathy or strained. If the muscles and nerves to the vocal folds are affected this can also change the vocal quality
- Resonance – voice sound amplified and modified by the vocal tract or resonators (throat, mouth and nasal passages)
- Articulation – voiced sounds are shaped by the articulators (tongue, soft palate, lips) to produce recognisable sounds and words.
How does cancer affect the voice?
The cancer itself and often the treatment for head and neck cancer, such as surgery and chemoRT can change a person’s vocal quality. The voice is complex and is made up of multiple sub-systems that need to work in a coordinated manner to produce a clear voice.
Cancer to the throat, either directly to the vocal folds or structures surrounding the vocal folds, can affect voice production. It may impact the clarity of the voice, the strength and volume of the voice or the effort required to produce voice. Dysphonia is a term to classify “difficulty making voice sounds”.
How can a voice change impact our patients?
Voice often defines who we are as people; it allows us to express our emotions and communicate our thoughts and needs. Voice loss may affect a person’s ability to perform their job, their ability to socialise, or even just express basic needs. Until someone loses their voice, most people don’t think about how significantly voice changes can impact someone’s life.
Read what some of our patients have said about how losing their voice:
- Les, tonsil cancer patient treated with chemoRT: “Initially my voice was pretty rough, I couldn’t talk too long and it was uncomfortable to talk. I was very down heartened and worried I wouldn’t get my voice back. Lucky I had a Speech Pathologist who helped me a lot by doing voice therapy exercises and my voice has returned to normal so I can return to work and can speak to my family and friends like I used to.”
- Peter, supraglottic cancer treated with chemoRT: “I’m a real chatterbox and I love a good chat to anyone that will listen. My voice suddenly went on me mid-way through treatment and it made me feel really uncomfortable not being able to communicate as I could before. People couldn’t understand me or hear me because I had no strength in my voice. I stopped answering the phone and my wife needed to take the calls instead. I didn’t let it get me down but I found it annoying that I had to keep my mouth shut.”
- Jon, laryngeal cancer treated with radiotherapy: “I need to use my voice for my job. It involves talking on the phone a lot and talking to customers for the first time often happens over the phone. When my voice started to change it really affected my ability to do my job. I was embarrassed to answer the phone as people always asked me if I was sick. My voice wasn’t lasting the distance and my wife was needing to step in and answer work phone calls on my behalf. I was then diagnosed with throat cancer. I lost my voice completely during treatment and after for a couple of months. My Speech Pathologist worked with me and gave me exercises to help get my voice back. 8 months on, my voice is not perfect but I can do my job. It still gets tried and I can’t always talk in social situations where there is a lot of noise.”
Renowned Australian radio broadcaster, journalist, comedian, and political commentator Julie McCrossin AM is a neck and neck cancer survivor. She shares her experience of voice loss below:
“I lost my voice completely for several weeks after radiation therapy to cure my HPV-related throat cancer in 2013. Many people expected me to worry about my capacity to work because I talk for a living as a radio, video and podcast presenter and MC. But I realised that what I really valued about my voice was conversations with my partner, children and friends.
Our voice is how we express love and share our feelings and ideas. I was very lucky to have an experienced and informative speech pathologist in my acute care team. She gave me exercises to do all through my 30 sessions of radiation and in the immediate weeks after treatment when the impact is most severe. She helped me to keep swallowing throughout treatment and she motivated me to keep doing vocal exercises.
My voice care was then transferred to another speech pathologist and I worked on my voice with her, with regular appointments, for over 12 months. As a professional voice user, I often wear headphones when I work. So I know what my pre-cancer voice sounds like.
My voice has recovered its original tone and timbre, although my singing voice does not have its original range. It is 8 years since I lost my voice. I am still very careful to avoid speaking in noisy rooms and I drink lots of water. I remember sitting at home doing my voice exercises for many weeks after treatment. I felt very vulnerable. I am eternally grateful for the care and psychological support of my speech pathologists.”
How do speech pathologists help with voice?
Speech Pathologists assess a patient’s voice and provide a range of therapy techniques to individually target the patient’s voice problem. Voice therapy aims to improve the quality of the patient’s voice to help them use their voice in whatever capacity they need or choose.
The speech pathology team at Peter Mac also assess and treat a wide range of speech, swallowing and communication difficulties. For more details on how Speech Pathology at Peter Mac can help and for referral information, click here.
What can we all do to keep our voice healthy and strong?
Speak at a comfortable volume.
When conducting virtual meetings, use only one ear of your headphones with inbuilt microphone, if possible. This allows you to hear your own voice and modulate your volume appropriately.
Schedule vocal rest breaks.
Keep well hydrated, including frequently drinking water and avoiding excessive caffeine.
- Seek help from an Ear Nose Throat specialist or Speech Pathologist if you experience pain, discomfort or voice changes that do not resolve.